Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 29-year old female, in her second pregnancy, complained of headache, nausea, vomiting and left blurred vision. In spite of improvement of these symptoms in the second postpartum, she complained of recurrent symptoms in her third pregnancy. CT and MRI showed a pituitary adenoma with hematoma. It was totally removed using the transsphenoidal approach during pregnancy at 8 months. The histological examination revealed that the tumor was an acidophilic adenoma with a hemorrhagic change. A healthy baby was born at the full term after the operation. Our transsphenoidal operation during pregnancy was only the second such attempt reported in our collected literature. The management of the pituitary tumor during pregnancy is discussed.
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PMID:[A report of a transsphenoidal operation during pregnancy for a pituitary adenoma]. 194 97

We report a patient with neurinoma of the spinal accessory nerve, who complained of intermittent occipital headaches, nausea, vomiting, blurred vision and unsteady gait. Neurological examination revealed papilledema, bilateral horizontal nystagmus and right cerebellar signs. Computed tomography revealed mild hydrocephalus, a low-attenuated lesion with a faint capsule after enhancement and partial compression of the 4th ventricle in the right posterior fossa. Vertebral angiography revealed no definite tumor vessels or stains. Under the impression of a posterior fossa tumor, a suboccipital craniectomy with a C1 and C2 laminectomy was performed. A 4 x 4 x 2.5 cm3 dumbbell tumor arising from the left spinal accessory nerve at the C2 level was found 4 x 4 x 2.5 cm3. The tumor extended upward through the foramen magnum with upward displacement of both tonsils to the right jugular foramen with slight adhesion to the right IX, X and XI cranial nerves. The left spinal accessory nerve was severed from the pedicle at the C2 level, and the tumor was totally removed. Diagnosis was made during the operation. The pathological examination showed neurinoma with cystic degeneration. During the following year, atrophy of the left sternocleidomastoid and trapezius muscles were noticed. Up to the time of this writing, there had been no clinical recurrence.
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PMID:Neurinoma of the spinal accessory nerve: report of a case. 197 3

Evidence from controlled clinical trials of oximes indicates that high doses given im or iv may cause transient disturbances of vision. Blurring of vision and diplopia present for up to an hour can occur. These are often accompanied by other side effects such as nausea, epigastric discomfort, drowsiness and dizziness. Visual effects have not been reported following high doses of oximes given po. Experimental studies provide evidence that some oximes given at high dosages may penetrate the blood-brain and blood-aqueous humor barriers. These suggest that the visual effects may be mediated through the CNS and/or by direct effects on the accommodation mechanisms of the eye. Although transient, the visual effects should be taken into account in clinical trials designed to assess the dosage necessary to achieve prophylaxis against OP antiChE poisoning in occupational situations.
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PMID:Ophthalmic effects of oximes: a review. 203 43

An epidemiological survey on 30,000VDT operators has been carried out to evaluate the relationship between asthenopia and monitor characteristics. A VDU operator has been classified as asthenopeic if he complained about at least two of the following ten symptoms: headache, tearing, eye smarting, blurred vision, double vision, ocular itching, photophobia, blinking, nausea, eye heaviness. Visual discomfort has been related to 1) the presence of flicker; the possibility to regulate, 2) brightness, 3) height; and 4) inclination of monitor. Asthenopia has resulted statistically correlated to the presence of flicker and to the impossibility of regulating height and inclination of monitor for both sexes. The possibility to regulate monitor brightness has not determined a reduction of visual discomfort either in men or in women.
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PMID:[Asthenopia and monitor characteristics]. 208 58

Pseudotumour was diagnosed in six patients aged 3-38 years during an 8 years period. The diagnosis was based on headache, papilloedema, normal CT scan and cerebrospinal fluid (CSF) composition. Additional clinical symptoms were nausea, VIth nerve palsy, ataxia, blurred vision and frank visual reduction over time. Sagittal sinus thrombosis was ruled out by angiography or magnetic resonance imaging. In five of the six patients lumbar steady state infusion tests were performed to evaluate intracranial hydrodynamics and CSF resorbtion. All patients demonstrated a markedly increased opening pressure (range 13 to 48 mm Hg). CSF outflow resistance ranged from upper normal to pathologically increased levels (8-19 mm Hg/ml/min). Combined epidural intracranial pressure/middle cerebral artery blood velocity monitoring in 3 patients revealed a great number of B waves and a labile cerebral vasomotor state. Pharmacological treatment was tried with digitoxin, acetazolamide, furosemide and/or corticosteroids. Two patients did well on long-term treatment with digitoxin and furosemide, respectively. In the other four patients the clinical development was unsatisfactory on medical treatment alone. They were subsequently operated with implantation of a lumboperitoneal, cisternoatrial or cisternoperitoneal shunt. Shunting rapidly reversed clinical signs and symptoms, except for a partial persistent visual loss in an 18 years old boy who had experienced symptoms for 3 years resistant to pharmacological treatment.
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PMID:Pseudotumour cerebri-neurosurgical considerations. 208 40

Nonsalicylate, nonsteroidal anti-inflammatory drugs (NSAIDs) can be divided into 4 chemical classes: acetic acids, fenamic acids, oxicams and propionic acids. Most NSAID overdoses result in a benign outcome. Of 50,614 exposures reported to poison centres in the United States in a 2-year period, 131 (0.26%) had a major outcome, with 10 deaths. Despite the generally mild effects reported in large patient series, isolated case reports have documented serious toxicity, such as seizures, hypotension, apnoea, coma and renal failure. The majority of these consequences occur after ingestion of substantial quantities by adults attempting suicide. Rarely, with ibuprofen and piroxicam, children who ingest small amounts in accidental exposure develop serious toxicity. Typical signs and symptoms of NSAID overdose include nausea, vomiting, headache, drowsiness, blurred vision and dizziness. Seizures are rarely documented across all NSAID classes, with the exception of mefenamic acid (where seizures occur in over one-third of cases), or following massive ingestion of other agents. Drugs in the propionic acid group have produced metabolic acidosis, respiratory depression and coma in severe cases. Ibuprofen is the agent with the most published data on overdose, probably because it is available without a prescription in many countries. Symptoms are unlikely after ingestion of 100 mg/kg or less, and are usually not life-threatening unless more than 400 mg/kg is ingested. There is some relationship between plasma concentrations and the potential for development of symptoms, but plasma concentrations have no impact on treatment decisions. Treatment of NSAID overdose is entirely supportive. Recent trends in emergency department procedures regarding gastric decontamination are evolving towards the recommended administration of activated charcoal without gastric emptying in patients presenting more than 1 hour after ingestion, although gastric lavage, followed by administration of activated charcoal, may be advisable in patients who present earlier. Home administration of syrup of ipecac is still recommended if treatment is given shortly after ingestion, with a few exceptions: for example, ipecac is contraindicated after ingestion of mefenamic acid or ibuprofen in amounts greater than 400 mg/kg. Urine alkalinisation and diuresis have been recommended to enhance the elimination of NSAIDs, based on a pKa in the range of 3 to 5. However, because the drugs are universally highly protein bound, with little unchanged renal excretion, this technique is not likely to be beneficial. Haemodialysis is also unlikely to enhance elimination, but may be required if oliguric renal failure develops. Multiple dose activated charcoal may be useful in enhancing elimination of NSAIDs with long half-lives, such as piroxicam and sulindac.
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PMID:Toxic effects of nonsteroidal anti-inflammatory drugs in overdose. An overview of recent evidence on clinical effects and dose-response relationships. 219 51

The influence of head down (HD) tilting on brain-stem auditory evoked responses (BAER) was studied in hypertensives with supine brain-stem disorders (occipital headache, vertigo, nausea, diplopia, blurred vision occurring after night recumbency), in hypertensives without such phenomena and in normotensives. In the latter two categories of subjects HD tilting had no effect on BAER. On the contrary, in hypertensives with supine brain-stem disorders the manoeuvre induced a constant prolongation of I-V and III-V intervals and a depression in the amplitude of wave V; the alterations of BAER produced by HD tilting reveal probably a dysfunction of the superior brain-stem area and might be due to the impaired cerebral venous draining subsequent to the manoeuvre. The study of BAER after HD tilting seems to be a proper means to attest the supine brain-stem disorders displayed by some hypertensives.
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PMID:Alterations in brain-stem auditory responses induced by head down tilting in hypertensives with supine brain-stem disorders. 224 34

A 19-year old woman who developed rapid nausea, vomiting, tachypnea, and alkalosis within 90 min of taking 3.25 g quinine S04 to induce abortion, was found to have an elevated anion gap and other electrolyte abnormalities. She was normovolemic, and had benign findings on drug screen except for quinine. Her abnormal laboratory values were high serum anion gap of 20 (normal 8-14), high urine anion gap of 171, low HC03- of 29 mEq/L, high Pa)@ of 130 mm Hg, alkalotic pH of 7.5, and hypokalemia of 2.6 mEq/L. Her hypokalemia was judged due to diuresis and vomiting. She was successfully treated with intravenous fluids and supportive care and was discharged on the third day. Quinine intoxication can also cause cinchonism, which is marked by tinnitus, vertigo, blurred vision and scotomata, and possible optic atrophy or death. The toxic dose is 2 g, and the lethal dose 8 g.
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PMID:Self-induced abortion and an elevated anion gap. 249 93

The three best-described genetic polymorphisms of drug metabolism--the debrisoquin/sparteine type of oxidative polymorphism (hereafter referred to as the debrisoquin polymorphism), the polymorphism of N-acetylation, and the mephenytoin type of oxidative polymorphism--are reviewed. For all three polymorphisms, the poor-metabolizer phenotype is inherited as an autosomal recessive trait. The debrisoquin and mephenytoin oxidative polymorphisms involve defects in two separate cytochrome P450 enzymes. The prevalence of the poor-metabolizer phenotype for debrisoquin ranges between 2% and 10% for groups of various ethnic origins. The poor-metabolizer phenotype for mephenytoin comprises about 5% of the Caucasian population and about 20% of the Japanese population. N-acetyltransferase is a cytosolic enzyme whose clinical polymorphism was discovered using isoniazid as the substrate probe. The prevalence of the slow-acetylator phenotype among American and European Caucasian and American black groups is about 50%; among the Japanese it is about 10%. More than 20 agents are substrates for debrisoquin hydroxylase, about 15 for N-acetyltransferase, and 3-5 for mephenytoin. In poor metabolizers, debrisoquin can cause hypotension, and sparteine can cause blurred vision, headache, and dizziness. Clinical consequences of the slow-acetylator phenotype include increased susceptibility to systemic lupus erythematosus induced by procainamide and hydralazine, peripheral neuropathy induced by isoniazid, hydralazine, and dapsone, and sulfasalazine-induced dose-related leukopenia, nausea, vomiting, headache, and vertigo. After administration of mephenytoin, poor metabolizers have increased somnolence and intellectual impairment. Awareness of genetic polymorphisms of drug metabolism should improve understanding of interindividual variability in drug disposition and response.
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PMID:Polymorphic drug metabolism. 268 60

Benzodiazepines are used as hypnotics to reduce anxiety and give a good night's sleep on the night prior to surgery. In a double-blind procedure, patients were given either lorazepam (2 mg or 4 mg), lormetazepam (1 mg or 2 mg), nitrazepam 10 mg or placebo. Measures were taken of sleep, anxiety, memory and after-effects. There was no evidence that the drugs reduced anxiety, nor evidence of amnesia. Quality and length of sleep was shown to be better for nitrazepam (P less than 0.05), lorazepam 2 mg (P less than 0.05) and lorazepam 4 mg (P less than 0.01), compared with placebo. However, significantly higher ratings of clumsiness and confusion as after-effects were found with nitrazepam (P less than 0.05), and clumsiness (P less than 0.005), slurred speech and blurred vision (P less than 0.01), sleepiness, nausea, weakness and confusion (P less than 0.05) with lorazepam 4 mg. It was concluded that lorazepam 2 mg produced the greatest net benefit.
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PMID:A double-blind comparison between nitrazepam, lorazepam, lormetazepam and placebo as preoperative night sedatives. 290 15


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